Psychological stress appears to contribute to poor oral health systemically in combination with other chronic diseases. Few studies directly examine this relationship. Data from a cross-sectional study of 2,412 participants between the ages of 25–64 years old living in the City of Toronto between 2009 and 2012 were used to examine the relationship between current stress and two self-rated oral health outcomes (general oral health and oral pain). Dental care utilization and access to dental insurance were examined as effect modifiers. A positive relationship between current stress and poor oral health was observed for both outcomes (oral pain coefficient 0.32, 95 % CI 0.26–0.38; general oral health coefficient 0.28, 95 % CI 0.19–0.36). Effects on oral pain were stronger for the uninsured, while effects on general oral health were stronger with decreasing socioeconomic position. Our findings suggest that individuals with greater perceived stress also report poorer oral health, and that this relationship is modified by dental insurance and socioeconomic position. These findings warrant a greater focus on the role of psychological stress in the development of oral disease, including how perceived stress contributes to health inequities in self-reported oral health status. Patients experiencing stressful lives may differentially require closer monitoring and more vigilant maintenance of their oral health, above and beyond that which is needed to achieve a state of health in the oral environment of less stressed individuals. There may be health promoting effects of addressing psychosocial concerns related to dental care - particularly for the poor and uninsured.

The purpose of this study was to quantify time loss due to dental problems and treatment in the Canadian population, to identify factors associated with this time loss, and to provide information regarding the economic impacts of these issues. Data from the 2007/09 Canadian Health Measures Survey were used. Descriptive analysis determined the proportion of those surveyed who reported time loss and the mean hours lost. Linear and logistic regressions were employed to determine what factors predicted hours lost and reporting time loss respectively. Productivity losses were estimated using the lost wages approach. Over 40 million hours per year were lost due to dental problems and treatment, with a mean of 3.5 hours being lost per person. Time loss was more likely among privately insured and higher income earners. The amount of time loss was greater for higher income earners, and those who reported experiencing oral pain. Experiencing oral pain was the strongest predictor of reporting time loss and the amount of time lost. This study has shown that, potentially, over 40 million hours are lost annually due to dental problems and treatment in Canada, with subsequent potential productivity losses of over $1 billion dollars. These losses are comparable to those experienced for other illnesses (e.g., musculoskeletal sprains). Further investigation into the underlying reasons for time loss, and which aspects of daily living are impacted by this time loss, are necessary for a fuller understanding of the policy implications associated with the economic impacts of dental problems and treatment in Canadian society.

Prior to the 2007/09 Canadian Health Measures Survey, there was no nationally representative clinical data on the oral health of Canadians experiencing cost barriers to dental care. The aim of this study was to determine the oral health status and dental treatment needs of Canadians reporting cost barriers to dental care.